RCM process can be improved by working on these areas
Charge Capture Accuracy: a. Regular charge reconciliation b. Detailed charge description master review c. Custom charge scripting. Using: Custom charge macros Custom charge forms Custom charge templates d. Charge capture audits e. Charge capture training for staff Claims Processing Speed: a. Claims editing software Use of: Claim scrubber software Claim validator software Claim editing software b. Automated claim submissions c. Pre-authorization management Parts: Pre-authorization request submissions Pre-authorization status tracking Pre-authorization appeal management d. Claim status tracking e. Claim denial management and appeals process Denial Management: a. Denial tracking and reporting b. Root cause analysis of denials c. Appeals management d. Re-billing of denied claims e. Denial prevention education for staff Revenue Optimization: a. Accounts Receivable (AR) aging analysis b. Contract management and negotiation c. Payment posting and reconciliation d. Charge lag analys...